Individual provider Active NPI

Sara Connemara, MS, CCC-SLP

  • Speech-Language Pathologist
  • Mequon, WI
National Provider Identifier
1174699474
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146008290 Issued in IL
Practice address
1017 W Glen Oaks LN Ste 140
Mequon, WI 53092-3371
Phone
(414) 533-8050
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146008290 IL Primary

Addresses

Primary practice location

1017 W Glen Oaks LN Ste 140
Mequon, WI 53092-3371

Mailing address

833 E Glenbrook Rd
Bayside, WI 53217-1436
Phone (414) 687-5986

Other practice location 1

2901 Finley Rd
Suite 102
Downers Grove, IL 60515-1041
Phone (630) 495-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146008290ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Speech Therapy LLC Speech-Language Pathologist CurrentSince Apr 24, 2022 Accepting new patients
Therapeutic Strategies, Inc Speech-Language Pathologist Past Accepting new patients
Communication and Feeding Specialists LLC Past Accepting new patients
Curative Care Network, Inc. Past Accepting new patients

Locations

1017 W Glen Oaks Ln
Ste 140
Mequon, WI 53092
Phone (414) 533-8050

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1174699474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 E GLENBROOK RD",
            "city": "BAYSIDE",
            "state": "WI",
            "postal_code": "532171436",
            "telephone_number": "414-687-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 W GLEN OAKS LN STE 140",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923371",
            "telephone_number": "414-533-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Finley Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605151041",
            "country_code": "US",
            "telephone_number": "630-495-6800",
            "fax_number": "630-495-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNEMARA",
        "first_name": "SARA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146008290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.